Enhanced recovery after surgery is feasible and safe in liver transplantation: a cohort study
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Enhanced recovery after surgery is feasible and safe in liver transplantation : a cohort study. / Hillingsø, Jens G.; Rostved, Andreas A.; Dengsø, Kristine E.; Sørensen, Carina L.; Frederiksen, Hans J.; Krohn, Paul S.; Petersen, Christian R.; Larsen, Peter N.; Fukumori, Daisuke; Burgdorff, Stefan K.; Kehlet, Henrik; Schultz, Nicolai A.
In: HPB, Vol. 24, No. 11, 2022, p. 2022-2028.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Enhanced recovery after surgery is feasible and safe in liver transplantation
T2 - a cohort study
AU - Hillingsø, Jens G.
AU - Rostved, Andreas A.
AU - Dengsø, Kristine E.
AU - Sørensen, Carina L.
AU - Frederiksen, Hans J.
AU - Krohn, Paul S.
AU - Petersen, Christian R.
AU - Larsen, Peter N.
AU - Fukumori, Daisuke
AU - Burgdorff, Stefan K.
AU - Kehlet, Henrik
AU - Schultz, Nicolai A.
N1 - Publisher Copyright: © 2022 International Hepato-Pancreato-Biliary Association Inc.
PY - 2022
Y1 - 2022
N2 - Background: The principles of enhanced recovery after surgery (ERAS) are being applied to still more advanced procedures. Liver transplantation offers a unique opportunity for a multimodal approach including donor care as well. Our objective was to determine if ERAS was applicable and safe in orthotopic liver transplantation (OLT). Methods: A national single centre retrospective study showing the implementation of ERAS from 2013 to 2019 with the proceeding 2 years serving as baseline. The primary endpoints were mortality, length of stay (LOS) in the ward and intensive care unit stay. Secondary endpoints were complications estimated by Dindo-Clavien classification, comprehensive complication index (CCI®) and re-admissions. Results: A total of 334 patients were included. LOS was significantly reduced from a median of 22.5 days at introduction to 14 days at 2019. Cold ischaemia time was reduced from a mean of 10.7 to 6.0 h and the use of blood products (erythrocytes, plasma and thrombocytes) from a median of 28 to 6 units. Complications were reduced in severity. Mortality and readmission rates were not affected. Conclusion: ERAS principles are safe and recommended in patients undergoing OLT resulting in reduced severity of complications and LOS without affecting re-admissions or mortality.
AB - Background: The principles of enhanced recovery after surgery (ERAS) are being applied to still more advanced procedures. Liver transplantation offers a unique opportunity for a multimodal approach including donor care as well. Our objective was to determine if ERAS was applicable and safe in orthotopic liver transplantation (OLT). Methods: A national single centre retrospective study showing the implementation of ERAS from 2013 to 2019 with the proceeding 2 years serving as baseline. The primary endpoints were mortality, length of stay (LOS) in the ward and intensive care unit stay. Secondary endpoints were complications estimated by Dindo-Clavien classification, comprehensive complication index (CCI®) and re-admissions. Results: A total of 334 patients were included. LOS was significantly reduced from a median of 22.5 days at introduction to 14 days at 2019. Cold ischaemia time was reduced from a mean of 10.7 to 6.0 h and the use of blood products (erythrocytes, plasma and thrombocytes) from a median of 28 to 6 units. Complications were reduced in severity. Mortality and readmission rates were not affected. Conclusion: ERAS principles are safe and recommended in patients undergoing OLT resulting in reduced severity of complications and LOS without affecting re-admissions or mortality.
U2 - 10.1016/j.hpb.2022.07.010
DO - 10.1016/j.hpb.2022.07.010
M3 - Journal article
C2 - 35973930
AN - SCOPUS:85136763079
VL - 24
SP - 2022
EP - 2028
JO - HPB
JF - HPB
SN - 1365-182X
IS - 11
ER -
ID: 329434696